Minneapolis Star Tribune, Feb. 9

Minnesota's health care 'fixer' takes on worthy new goal

After eight years of political warfare over the Affordable Care Act, there's a hopeful lesson to be drawn from the demise of Republican efforts last summer to repeal the landmark health reform law: Common ground still exists when it comes to health care.

What really doomed the GOP bill, even more than Republican U.S. Sen. John McCain's thumbs-down moment, was the groundswell of citizens who agreed on important principles — access to affordable care, and protection from financial devastation if serious illness occurs. It wouldn't have come down to McCain's vote had it not been for advocates' phone calls to Congress, the searing stories shared by parents of disabled children and the campaigns launched to help the public understand that their friends and neighbors are the beneficiaries of Medicaid and other public programs

Not only must this collective energy be sustained, its focus must shift. Defeating last summer's ill-advised repeal-and-replace bills isn't enough. Advocates must now construct better policy and build support for it. That one of Minnesota's own — former UnitedHealth Group executive Andy Slavitt — has launched an innovative initiative to do this burnishes the state's reputation as a health care pioneer.

Slavitt, 51, of Edina, announced the creation of a new nonprofit on Tuesday. Its name — "United States of Care" — and its politically diverse board of directors and advisory council sends a welcome signal. The mission isn't to advocate for one political party's preferred solution. The initiative instead seeks solutions from across the political spectrum — a smart step because otherwise the political battles over reforms will never end. The group won't lobby, but the strategies it will employ include amplifying patients' voices, enlisting employers' support for policy changes and serving as a technical resource for lawmakers, particularly at the state level.

To Slavitt's credit, he realizes this is a long-haul effort. In his view, political cycles provide a window for real health reform roughly every decade. His nonprofit is preparing for that — now. "How do we put in place the building blocks the next time we go at this?" he said last week. "How do we get a better outcome that the American public deserves?"

Many initiatives have taken runs at Slavitt's "changing the health care narrative" goal. But United States of Care looks as if it can substantially move the needle. One reason: the lineup of health care all-stars serving on its board or on its founder's council. They include former Republican U.S. Sen. David Durenberger of Minnesota; physician and health care author Atul Gawande; Elena Hung of the "Little Lobbyists" advocacy group; physician and former Tennessee U.S. Sen. Dr. Bill Frist, and Dr. Penny Wheeler, the innovative CEO of Minnesota's own Allina Health.

Slavitt's personal involvement also creates high expectations. As a former executive, he has the private-sector experience and the personal resources to help fund the new nonprofit. He also served in one of the top health care posts under former President Barack Obama. He's probably best known as the wonk brought in to fix healthcare.gov after the website's disastrous launch.

His Obama-era service may create doubt about the nonprofit's nonpartisan mission. It shouldn't. "Andy pairs a deep understanding of U.S. health care with a unique ability to execute honed over years as a private-sector leader. And as the bipartisan make up of United States of Care demonstrates, Andy's expertise is recognized by Republicans and Democrats," said Denis McDonough, the Minnesota native who served as Obama's chief of staff.

Slavitt's social media influence also sets the nonprofit apart. His wife, Lana, is a social media force, too. They use Twitter to drive home health reform's moral mission: taking better care of Americans young and old. They have forged an online community of nearly 200,000 followers and encouraged others who need care, or have loved ones who do, to speak out.

There have been many calls for a "patient-centered" health care system. Slavitt has already started the work of building that model, and his new initiative will admirably drive reform forward with this unifying principle. Slavitt merits Minnesotans' support as he attempts another ambitious repair: mending the nation's still-broken health care system.

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Mankato Free Press, Feb. 11

Prescription drugs: Trump plans won't impact prices much

While President Donald Trump has finally put some action behind his tough talk to lower "outrageous" prescription drug prices, his recent proposal will barely scratch the surface.

And it treats the pharmaceutical industry with kid gloves. Instead, it puts pressure on hospitals, doctors and benefit managers to suffer the pain of lowering prescription drug prices.

There is nary a word from the president or his team about the obvious strategy of simply allowing Medicare to negotiate volume discounts directly with drug companies to meet the needs of 41 million seniors. Such negotiating is still strictly prohibited by law.

There is nothing about supporting bipartisan bills by Sen. Amy Klobuchar and Republicans Sens. John McCain of Arizona and Charles Grassley, of Iowa. Those three powerful and prominent senators have called for laws allowing for importation of safe prescription drugs from Canada and creating greater access to generics by restricting payoffs pharmaceutical companies make to keep generics off the market.

Trump's plans call for requiring benefit managers who negotiate with drug companies to pass along some of the saving to seniors. It sounds like a fine idea, but in reality, it simply puts market pressure on the benefit manager to split their discount and make up for it by raising health insurance premium prices.

Another plan calls for moving some medical treatments and sophisticated injection treatments to another area of Medicare where they would be subject to more negotiation, again, from a third party. In that case, the hospital and doctor mostly pay for the reduction in cost, not the pharmaceutical company.

Another plan would redistribute savings hospitals get from discounted prescriptions drugs because they serve a high number of poor patients. Again, the hospitals lose on this one.

So far, the pharmaceutical companies do not appear to be worried about the Trump proposals. The Nasdaq Biotechnology stock index was still on the rise Friday morning.

We urge the president and his health and human services secretary to embrace the Klobuchar bipartisan proposals to allow Canadian imports and remove anti-competitive rules about allowing generics on the market.

Ultimately, only allowing Medicare to negotiate prescription prices with the drug companies will bring significant change to the prescription drug monopoly.

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The Journal of New Ulm, Feb. 11

Off to the races

For the past five years or so, federal spending has been limited by sequestration, a system that Congress passed to reduce federal spending deficits by $1 trillion over ten years. It put caps on federal spending, and decreed that any increase in spending would have to be balanced by spending cuts or revenue increases somewhere else. Even with that in place the national debt continues to grow. The federal budget deficit was $666 billion in 2017, driving the national debt to over $20 trillion.

Well, hold on to your hat.

The two year spending bill passed by Congress early Friday morning will add another $300 billion over the next two years, with no counterbalancing cuts or revenue enhancements. In fact, combined with the federal tax reforms passed in December, which are expected to raise the deficit $1.5 trillion over the next ten years, the deficit appears to be heading for the stars.

Congress seems to have given up on the idea of setting spending limits before appropriating funds. There's little interest in fiscal restraint. After five years of sequestration, it's time for a bipartisan blowout.